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Impact of early caffeine therapy in preterm newborns on infant lung function
Manuel Sanchez-Solis1,2, Patricia W Garcia-Marcos3, Juan Agüera-Arenas4
1Surgery, Pediatric, Obstetric and Gynecology Department, University of Murcia, Murcia, Spain.
Insights
Caffeine therapy improves infant lung function, specifically forced vital capacity (FVC) and forced expiratory volume at 0.5 seconds (FEV0.5), in preterm infants under 31 weeks. This benefit was most notable in infants without bronchopulmonary dysplasia (BPD).
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Pharmacology
Background:
- Preterm infants, especially those born before 31 weeks gestation, are at high risk for impaired lung function.
- Bronchopulmonary dysplasia (BPD) is a common complication in these infants, further compromising respiratory health.
- Caffeine is a widely used stimulant in neonatal care, but its specific effects on early lung function require detailed investigation.
Purpose of the Study:
- To evaluate the impact of caffeine therapy on key infant lung function parameters.
- To determine if caffeine treatment influences lung function in preterm infants (<31 weeks gestation).
- To assess the effect of caffeine, considering the presence or absence of bronchopulmonary dysplasia (BPD).
Main Methods:
- Lung function was assessed using forced vital capacity (FVC), forced expiratory volume at 0.5 seconds (FEV0.5), and other measures via rapid thoracoabdominal compression and plethysmography.
- Respiratory system compliance (Crs) was measured using a single interruption technique.
- Multivariate analysis compared lung function between caffeine-treated and non-treated groups, adjusting for factors like gestational age, birth weight, and BPD status. Stratified analyses by BPD were also performed.
Main Results:
- Multivariate analysis revealed significantly higher z-scores for FVC and FEV0.5 in preterm infants receiving caffeine therapy (P=.004 and P=.024, respectively).
- This improvement in FVC and FEV0.5 was statistically significant only in the subgroup of infants without BPD (P=.021 and P=.042).
- No significant differences were observed in FEV0.5/FVC ratios, forced expiratory flows (FEF75, FEF25-75), functional residual capacity (FRCpleth), or Crs between the groups.
Conclusions:
- Caffeine therapy demonstrates an early beneficial effect on infant lung function, specifically improving FVC and FEV0.5 in preterm infants (<31 weeks gestation).
- The observed lung function improvements are primarily driven by infants who did not develop BPD.
- These findings support the early use of caffeine as a potential therapeutic strategy to enhance respiratory outcomes in vulnerable preterm infants.
Objective:
To know the effect of caffeine therapy on infant lung function in preterm infants with a gestational age less than 31 weeks.
Material And Methods:
Forced vital capacity (FVC), forced expiratory volume at 0.5 seconds (FEV0.5 ), and forced expiratory flows were measured by raised volume rapid thoracoabdominal compression technique; functional residual capacity was measured by plethysmography (FRCpleth ). Compliance of the respiratory system was measured by a single interruption technique (Crs). The Student t test was used to compare lung function measurements between the two groups: treated versus nontreated with caffeine. A multivariate analysis was carried out considering each and every lung function parameter (z-score) as the dependent variable; and gender, gestational age, birth weight (z-score), corrected age, invasive mechanical ventilation (yes/no), and bronchopulmonary dysplasia (BPD) diagnosis (yes/no) as independent ones. Additionally, stratified analyses by BPD diagnosis were performed.
Results:
The multivariate analysis showed significant higher z-scores of FVC and FEV0.5 in preterm infants treated with caffeine (P = .004 and P = .024, respectively). This result only being significant in the group of non-BPD infants (P = .021 and P = .042), after stratifying by BPD diagnosis. Differences were not found in z-scores of FEV0.5/FVC, FEF75, FEF25-75, FRCpleth, nor Crs.
Conclusion:
Lung function (FVC and FEV0.5 ) is improved in infants born under 31 weeks of gestation when treated with caffeine. This improvement is driven by the group of infants who did not suffer from BPD. Overall, our results show that there is an early beneficial effect of caffeine treatment in infant lung function.
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